The opioid crisis: Addicted at birth

By: Paige Hill

Infographic on neonatal abstinence syndrome in Tennessee using information from 2019. Courtesy of Paige Hill.

    Hospital staff have trained their ears to the cry of babies suffering with Neonatal Abstinence Syndrome. It is like a scream that does not stop until the drug is out of their system.


    “Babies with NAS have a very distinct high-pitched cry. They can feed poorly, and their muscles are very stiff,” said addiction family doctor Ray W. Mettetal Jr. “They can be completely inconsolable, overall, they are just completely miserable.” This is a painful withdrawal the newborns experience after becoming dependent on drugs while inside the womb.


    Newborns can also develop seizures, problems with sleeping, increased irritability, vomiting, diarrhea, sweating and fevers over the course of their withdrawal to the substance.


    Symptoms of NAS can begin from one day to one week after birth and can last up to four to six months, depending on the case of severity and drugs which were used.


    According to the National Institute on Drug Abuse, there has been an increase in the proportion of newborns suffering from an opioid withdrawal. NAS newborns are more likely than other non-NAS newborns to have lower birth weight and respiratory complication at the time of birth, as well as in the future.


    “Babies who have a history with NAS have lower IQ scores than peers who did not, but the scores are not out of the normal range,” said assistant professor Alyson Chroust. Mothers may be taking opioids illegally or for Medication Assisted Treatment. If a woman has an opioid prescription and gets pregnant, her doctor will most likely use this treatment option to put her on other drugs that can help her needs and not be as harmful for her fetus as unregulated drugs are. This assisted treatment can also be a treatment for women who are using illicit street drugs.


    “The American Board of Addiction agree that it is best not to put pregnant mothers into full withdrawal,” said Dr. Mettetal. “It can cause miscarriages or relapse on street drugs.”


    Non-medical prescription opioid use has almost quadrupled in the last two decades, according to the National Survey on Drug Use and Health. Since 2003, the Appalachian region has endured the rise of opioids. The issue has also narrowed in on parts of West Virginia, Virginia and Kentucky.


    According to the Tennessee Department of Health, there have been 358 cases of NAS since Jan. 1 of this year. The highest rates of NAS in 2019 have occurred in the Northeast and upper Cumberland regions of Tennessee.


    The increased amount of NAS and Opioid Use Disorder that affect smaller rural communities point to the fact that these conditions are more likely when health care is limited. Over 80% of diagnosed infant health care was paid by state Medicaid programs, which reflects greater maternal opioid use during pregnancy to be from lower-class income regions.


    According to the National Institute on Drug Abuse, the opioid crisis in the U.S. has become a public health crisis with devastating consequences including increase in misuse, overdose and NAS.


    From 2004 to 2014, 32,000 babies were born with NAS nationwide, which is equivalent to one baby suffering from opioid with-drawal born approximately every 15 minutes.


    Neonatal Abstinence Syndrome is completely preventable, but it requires that a mother stop using drugs before becoming pregnant or talking to a doctor about the safest way to adhere to the mother and infants needs after consuming a drug. 

This project was born out of a desire to cover the issues that face our community and region, specifically the Appalachian Highlands, The Blue Ridge Mountains, and Greater Appalachia.

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